Carol KimWe are your Health Net.Carol Kim If you don’t have health coverage, you are not alone. Maybe your job

doesn’t offer it. Or maybe your health has made it hard to get. For

millions of people, it is not affordable.

All that is about to change!

You may have heard about health care reform. The law is called the

Affordable Care Act. Some people refer to it as Obamacare.

The goal is to make health coverage easier to get and more affordable.

The new health care marketplace is one of the ways to help you do that.

What is a health care marketplace? It is a new way you can shop for a� ordable, high-quality health coverage. � e marketplaces are sometimes called exchanges. You can shop and apply for coverage online. Or you can apply by phone, by mail or in person at places in the community.

Every state has to have a marketplace open by October 1, 2013. You can buy health coverage when the marketplaces open. Your coverage can start as early as January 1, 2014. � ere is � nancial help for people who qualify.

� e New Health Care Marketplace

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� e New Health Care Marketplace

Health 101 from Health Net

Health Care

MARKETPLACE

A� ordable, high-quality health coverage

How much do I have to pay?

� ere are two parts to what you pay.

What can I buy?

You can buy health coverage through the marketplace. You can buy it if you are:

• a resident of the state where you are buying health coverage,

• a U.S. citizen/national,

• lawfully present in the U.S., and

• not incarcerated.

You have your choice from di� erent health coverage companies. You cannot be denied coverage even if you have a medical condition. If you are age 65 or over, you may be eligible for Medicare.

Coverage comes in four “metal” levels:

All companies offer the same standard benefi ts on each level. So...

Silver plan from Company A

Silver plan from Company B

=

That makes it easy to compare.

Silver plan from Company B

That makes it easy to compare.

When you buy a health

plan, you get:

Doctor visits

Prescription drugs

Urgent care

Hospital services

Preventive care

and more

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This is the share of costs you pay when you use health services.

$$$ Bill

This is the cost you pay every month whether or not you use services.

You might have a third part to

pay. It is called a deductible.

Some types of health coverage

have a deductible. This is the

amount you owe for some

covered health care services

before your health plan begins

to pay.

2 Copayment or coinsurance1 Monthly premium

How much you pay in premiums and copayments depends on the health coverage level you choose. � is chart shows you how it works.

Each of the four metal levels is based on the total average costs for benefi ts that a plan covers. That means a platinum plan will cover the most when you use services. The trade-off is the premium will be higher.

What you pay vs. what the health coverage company pays

= You

= Health coverage company

Platinum Gold Silver Bronze

% of costs paid by health planHighest Lowest

10% 20% 30% 40%

90% 80% 70% 60%

Your out-of-pocket costs for servicesYour out-of-pocket costs for servicesYour out-of-pocket costs for servicesLowest Highest

Platinum Gold Silver Bronze

Can I get help paying for health care coverage?

� e government is giving � nancial help to people who qualify. � e less income you make, the less you pay. � ere are two kinds of help (shown at right). You have to buy your plan through a state or federal health insurance marketplace to get this � nancial help.

In 2014, the penalty for a single person is

$95 or 1%of income– whichever is more.

You can fi nd out what

you will pay by using

your state’s online

calculator. See back

page for website

address.Do I have to buy health coverage?

Most American U.S. citizens, U.S. nationals and resident aliens have to be enrolled in a health insurance plan that meets minimum essential coverage. People currently insured through an employer or a plan they bought on their own likely meet the requirement already. So do those enrolled in a Medicare plan, TRICARE, Medicaid, and a few other programs.

People who are required to have health insurance but choose not to buy it have to pay a penalty when � ling their taxes. � ere are a few exceptions. You can learn about these exceptions at www.coveredca.com.

50%50%

Minimum coverage optionThere is also a minimum coverage option for people under the age of 30. It is also an option for people having fi nancial hardship. It is a high-deductible health plan with a lower monthly premium. People who have this plan have to meet the $6,350 deductible fi rst. Then benefi ts for covered services are generally 50%.

Premium assistance lowers the cost you pay every month for health care coverage.

Monthly Bill$$$

$

Cost-sharing reductions lower what you pay for services like doctor visits.

What you pay vs. what the health coverage company pays (continued)

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Health Net can help you � nd out what you will pay based on your income and the number of people in your family. We will also help you � nd the coverage level that � ts you best. Call us at 1-877-609-8707.

Learn more

Call Health Net at 1-877-609-8707.

We will help you look at your choices.

We can tell you if you can get low-cost or no-cost health coverage.

We can help you sign up.

We are your Health Net.

6029574 CA104934 (9/13)Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. Covered California is a registered trademark of the State of California. All rights reserved.

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Covered CaliforniaCalifornia’s marketplace is called Covered California. www.coveredca.com 1-888-975-1142